Provider Demographics
NPI:1568622645
Name:JAMES P THOMPSON MD PA
Entity Type:Organization
Organization Name:JAMES P THOMPSON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SHINDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-822-0424
Mailing Address - Street 1:8420 OCEAN GTWY
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-7169
Mailing Address - Country:US
Mailing Address - Phone:410-822-0424
Mailing Address - Fax:410-822-2283
Practice Address - Street 1:8420 OCEAN GTWY
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-7169
Practice Address - Country:US
Practice Address - Phone:410-822-0424
Practice Address - Fax:410-822-2283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063440207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD406795900Medicaid
MD284MMedicare PIN